Opinion: Best interest' meetings are a fairly modern concept in the NHS and they offer a mixed bag.

In essence they are a great idea as they aim to make sure that decisions made about a patient ward discharge, for example, is all about what is in the patient's best interest.

Look online for 'best interest meetings NHS' and you will find a ton of information including checklists and guidance for staff holding such a meeting.

Imagine you suffer a stroke which leaves you unable to speak, have no children but some unscrupulous relatives who have an eye or two on your property, money and possession. You could and would be at their mercy. A ward best interest meeting on your individual case can pre-empt and prevent the worst happening but as always there is a but.

Having come across best interest meetings working for the NHS I have had some concerns for some time. Last week a bus stop and bus journey chat with an elderly lady brought them back to the surface.

The woman in question was travelling to visit her elderly husband who has been an inpatient at our main hospital since February 2015; she has been making this journey each day since that time.

That is a long time especially when you consider the NHS never has enough beds to cope with demands.

As we chatted I learned that the man went in hospital for a knee operation but sadly the wound became infected. This resulted in a further operation when the wound and knee were cleaned out. However the infection remained.

He was becoming a little more mobile but surgeons planned to put him under the knife for a further time and remove the kneecap. But the man suffered a stroke, something he had experienced when younger.

This time however, aged 80 plus, recovery from the stroke has its problems; he is currently unable to communicate.

All the wife wants is hubby home but a 'best interest meeting' has decided that is not an option.

She walks with a stick but otherwise seems competent. However she would no doubt struggle to care for her husband without a good care package.

It now looks as if husband will go to a stroke unit, which are very good locally. Often a patient stays there for around six weeks but in this case it may be longer.

So while the best interests of Mr X are being assessed who is assessing the best interests of Mrs X?

You can argue this one many ways but perhaps a good place to start is the fact that the man acquired a hospital infection which set off this chain of events; the wife believes the stroke was brought on by stress and worry about further surgery but that we will never know.

But the chat left me with a mixed bag of feelings.

Unless the woman is helped she will be the next big so-called 'drain' on the NHS.

She obviously misses her husband after many years of marriage. Ideally a care package that allows them to be together in what could be their last years or even months should be the option.

The cost of keeping them apart is great in many ways but far from ideal.

The teams working toward the man's hospital discharge will hopefully ensure that his best interests are met but their view of his best interests may differ from yours, mine and his and hers.

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